Idiopathic hypercalciuria is a cause of a variety of urinary tract complaints in clinical pediatrics. These include gross or microscopic hematuria, enuresis, urinary frequency or urgency, dysuria, sterile pyuria, and proteinuria in addition to renal calculi. A random urine calcium-creatinine concentration ratio can be used to initially screen for hypercalciuria. Patients with indeterminate results should have the test repeated, while those with abnormal values should receive a complete metabolic workup to determine the cause of hypercalciuria. Identifiable causes of hypercalciuria should be treated specifically, and thiazide diuretics are the preferred treatment for uncomplicated renal calculi. Pharmacotherapy in children with idiopathic hypercalciuria and symptomatology other than renal stones is controversial and should be limited to patients with severe clinical manifestations.
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References
1.
Moore ESHypercalciuria in children. Contrib Nephrol1981;27:20-31.
2.
Royer P.Explorations biologiques du metabolisme calcique chez l'enfant. Helv Pediatr Acta1961;16:320.
3.
Macy I.Nutrition and chemical growth in childhood. Spring-field, IL: Charles C Thomas Company1946 ;2:138.
4.
Moore ES, Coe FL, McMann BJ et al. Idiopathic hypercalciuria in children: prevalence and metabolic characteristics. J Pediatr1978;92:906-10.
5.
Stapelton FB , Noe HN, G. Jerkins, et al. Urinary excretion of calcium following an oral calcium loading test in healthy children. Pediatrics1982;69:594-7.
6.
Hufnagle KG, Khan SN, Penn D., et al. Renal recalcifications: a complication of long-term furosemide therapy in preterm infants. Pediatrics1982 ;70:360-3.
7.
Goldsmith MA , Bhatia SS, Kanto WP, et al. Gluconate calcium therapy and neonatal hypercalciuria. Am J Dis Child1981; 135:538-43.
8.
Rodriguez-Soriano J., Edelmann CM Jr.Renal tubular acidosis. Ann Rev Med1969;20:363-82.
9.
Bremer RJ, Spring DB, Sebastian A., et al. Incidence of radiographically evident bone disease, nephrocalcinosis, and nephrolithiasis in various types of renal tubular acidosis. N Engl Med1982;307:217-21.
10.
Brodehl J.The Falconi syndrome. In: Edelmann CM, ed. Pediatric kidney disease. New York: Little, Brown, and Co, 1980:961.
11.
Bean AGWilson's disease. In: Standbury C , ed. The metabolic basis of inherited disease. 3rd ed. New York: McGraw-Hill , 1976:1033.
12.
Choie DD, Richter GWEffects of lead on the kidney. In: Singhal RL, Thomas JA, eds. Lead toxicity. Baltimore: Urban and Schwarzenberg, 1980:187.
13.
Coe FL, Parks JH, Moore ESFamilial idiopathic hypercalciuria. N Engl J Med1979;300:337-40.
14.
Hyman LR, Boyer G., Thomas JC, et al. Immobilization hypercalciuria. Am J Dis Child1972;124:723-7.
15.
Edwards BR, Baer PG, Sutton Ral, Dirks JHMicropuncture study of diuretic effects on sodium and calcium reabsorption in the dog newborn. J Clin Invest1973;52:2418-27.
16.
Pak Cyc, Ohata M., Lawrence ECThe hypercalciurias. Causes, parathyroid function, and diagnostic criteria . J Clin Invest1974;54:387-400.
17.
Costanzo LA , Weiner IMOn the hypocalciuric action of chlorthiazide . J Clin Invest1974;54:628-37.
18.
Coe FL, Favus MJ, Crockett T., et al. Effect of low-calcium diet on urine calcium excretion, parathyroid function, and serum 1,25(OH)2D3 levels in patients with idiopathic hypercalciuria and in normal subjects. Am J Med1982; 2:25-32.
19.
Coe FL, Canterbury JM, Firpo JJEvidence for secondary hyperparathyroidism in idiopathic hypercalciuria . J Clin Invest1973;52:134-42.
20.
Royer P., Gerbeaux S., Frederick A.L'hypercalciurie idiopathique avec nanism et atteinte renale chez l'enfant. AnnalesPediatrie1962 ;9:147.
21.
Stapeltan FB , Noe HN, Roy S. III, et al. Hypercalciuria in children with urolithiasis. Am J Dis Child1982; 136:675-8.
